可吸收性材料辅助自体半腱肌腱移植重建兔前交叉韧带组织学转归实验研究

Histological Study on Semitendinosus Tendon Autograft with Biodegradable Material for Anterior Cruciate Ligament Reconstruction in Rabbit Model

目的:观察可吸收性材料(polyglactin 910)辅助自体半腱肌腱移植重建兔前交叉韧带(anterior cru-ciate ligament,ACL)术后的组织学变化过程,探讨可吸收性韧带加强装置(ligament augmentation device,LAD)在ACL修复与重建中的应用。方法:取新西兰大白兔同侧自体单股半腱肌腱移植重建双膝ACL,左膝在移植物中间纵向贯穿可吸收线进行辅助,作为实验侧,右膝不加可吸收线作为自身对照侧。分别于术后2周和1、2、4个月取材,肉眼观察关节腔内重建移植物的大体形态;运用HE染色观察关节腔内重建韧带中可吸收线的组织学变化。结果:关节腔内重建韧带中间的可吸收线在术后2周未见明显变化,1个月有降解吸收表现,2及4个月未再观察到可吸收线。术后各取材时间点,实验侧和对照侧的关节腔内重建移植物的肉眼和组织学表现无差别。结论:置于ACL重建移植物中间的可吸收性材料在术后2周～2个月内随自身新生组织的长入而逐渐被降解吸收,最后被胶原纤维组织完全替代,与胶原纤维组织表现出良好的组织相容性,对重建移植物的组织学转归无影响。

Objective To observe the histological change in semitendinosus tendon autograft augmented by biodegradable material（suture） for anterior cruciate ligament（ACL） reconstruction, and the possibility of applying this biodegradable ligament augmentation device （LAD） in the repair and reconstruction of ACL. Methods We performed bilateral ACL reconstructions in a rabbit model using a single ipsilateral semitendinosus tendon autograft in both knees. In the left knee（experimental side）, the autograft was augmented by biodegradable suture（polyglactin 910）. In the right knee （control side）,the autograft was not augmented by biodegradable suture. Specimens were collected at week 2 and 1,2 and 4 months after surgery. The gross morphology of the intraarticular segment of the graft was observed. The histological change in the biodegradable suture and the graft was studied by haematoxylin-eosin staining（HE）. Results The biodegradable suture within the graft remained unchanged 2 weeks after surgery. It began to degrade 1 month after surgery and could not be found 2 months after surgery. There were no differences in morphologic and histological appearance of the graft between the experimental side and the control side at any time period. Conclusion The biodegradable material in the middle of the graft degraded gradually with growing of new tissue into the graft and was absorbed completely,as well as substituted by collagen fibers by 2 months after surgery. The biodegradable material reveals good biocompatibilities to collagen fiber tissue without influence on the transformation of the graft.